Duty to Warn

Duty to warn is phrase used in medical care regarding an ethical duty to warn patients or research participants or anyone at risk of the potential harm. My own health and my experience helping others has made me appreciate wellness and sharing what has helped or what can be harmful are things I feel ethically it is my duty to warn or inform anyone who might be interested. We are one – your pain is my pain and the Earth needs more health. It is hurting too.

Empathy – feeling emotionally connected can also feel painful, a short article discusses the idea of the pain that may occur with feeling compassion for other’s suffering:

The Agony of Being Connected to Everything in the Universe, (andrewboyd.com)

The words sympathy, empathy and compassion are used somewhat interchangeably however they can refer to slightly different things. In medical settings the care of patients can be affected positively or negatively by how the caregiver provides help. Research with patients receiving cancer treatment found that patients felt that empathy and compassion were beneficial while sympathy was perceived more negatively. Compassion was felt to be most beneficial by the patients. What is the difference? Sympathy seems to be regarded as pity-based remarks or attitude about the chronic illness that was offered without having been asked, with less of a feeling of being understood. Empathy may be closer to feeling emotionally understood and compassion included feelings that the caregiver was acting with love and kindness out of a altruistic – giving mindset. (3) The risks of rudeness in a medical setting and possible value of kindness is discussed in a review of a research study on rudeness in a neonatal clinic setting: A Message to you Rudy, about Rudeness, SGEM#227.

Feeling like there is a physical problem and being told that it must be hypochondria or mental illness is not as helpful as being told that a reason for the symptoms are unknown at this time. Chronic itch, chronic pain and other vague symptoms of inflammation may be labeled as psychosomatic instead of unknown cause. Overactive TRP channels can be involved in chronic itch and chronic pain and the variety of possible substances and other reasons for a flair up in symptoms can make it very difficult to notice the pattern. I would rather be told we don’t know what is causing your symptoms than to be told to see a talk therapist or to be prescribed medications for mental illness that may cause additional symptoms due to side effects. The following chart is something I created after noticing a pattern, a very complex pattern, in my own symptoms and researching what the connection might be —- TRP channels. Not all substances or factors would cause symptoms for all of the conditions or for all people with a certain type of condition, however they may in larger amounts, or they may when the symptomatic condition is in a more severe state of inflammation. In reading about patients with some types of chronic itch symptoms I could feel their itchiness and mental hurt when treated as just difficult patients with anxiety problems – anxiety other extreme itchiness perhaps.

More about chronic itch and inflammatory stress conditions is available within a longer page/chapter I wrote about G3:Relaxation & StressG3.5: Negative stress chemicals may cause symptoms like itching, migraines, pain or IBS. (effectivecare.info) Preeclampsia is a prenatal condition that can become life threatening for the woman and expected infant and it affects a significant percentage of pregnancies – more information about TRP channels and a physical position that might help reduce internal pressure on the channels is available in the section on G5: Preeclampsia & TRP Channels. It is a yoga style position that was recommended to reduce risk of a breech birth during my own pregnancies and I found it relaxing. (effectivecare.info) I feel a duty to warn – a duty to inform other expectant mothers about a simple strategy that might protect their infant from a potentially life-threatening condition.

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1. Shah SK, Hull SC, Spinner MA, et al. What Does the Duty to Warn Require? The American journal of bioethics : AJOB. 2013;13(10):62-63. doi:10.1080/15265161.2013.828528. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816221/
  2. Andrew Boyd, The Agony of Being Connected to Everything in the Universe, andrewboyd.com http://andrewboyd.com/the-agony-of-being-connected-to-everything-in-the-universe/
  3. Sinclair S, Beamer K, Hack TF, et al. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliative Medicine. 2017;31(5):437-447. doi:10.1177/0269216316663499.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405806/
  4. Dr. Simon McCormick, SGEM #227: A Message to you Rudy, About Rudeness, Aug. 22, 2018, A Skeptic’s Guide to Emergency Medicine, http://thesgem.com/2018/09/sgem227-a-message-to-you-rudy-about-rudeness/

World Suicide Prevention Day

First, do no harm – I share information because I have been ill, physically and mentally and managed to get better for the most part. Not one hundred percent better though, prevention is the best medicine, or second only to laughter. Mental illness is treated as if it is separate from physical health and largely the two are very connected. I have improved but it has been with many lifestyle and dietary changes – every day, or at least most days of the week. Getting a genetic screening done and finding out more specifically what was different about me also was necessary.

Metabolism is a fancy word for the body’s many chemical reactions that burn energy and use it to combine nutrients from the diet and oxygen from the air for the purpose of building and repairing cells. Most cells other than brain cells are regenerated on a regular basis. Old ones are dismantled and new ones replace them on a time cycle that varies with the type of body part. If our individual genetic coding has differences sometimes we need more or less of some nutrients and possibly additional types of chemicals that in normal health could be manufactured within normal metabolic pathways. Mental illness including depression and suicidal urges can have to do with emotional issues or history of trauma but there can also be nutrient deficiencies causing too much or too little of some types of brain neurotransmitters/messenger chemicals.

Twenty percent of adults in the U.S. have a mental illness and twenty-two percent of young adults. Magnesium deficiency can be a cause of anxiety and depression. (Magnesium: an Essential Supplement for Psychiatric Patients, PsychiatryAdvisor) Magnesium is commonly low in people with chronic pain or migraines, diabetes, and other chronic conditions too. (Dietary Magnesium Intake in a Nationals Sample of U.S. Adults, The Journal of Nutrition) Topical creams or a soak in Epsom salt may be better absorbed for people with a digestive malabsorption problem — if there is magnesium in the diet but the digestive system isn’t absorbing it then there still may be symptoms such as muscle cramps, pain, or anxiety and depression. (See previous post on magnesium)

Crisis line: Suicide Prevention Lifeline at (800) 273-8255 for confidential support 24/7, for Veterans or their families, press 1 to then reach the Veterans Crisis Line.

Other resources for LGBTQ support: see link.

Crisis lines for a variety of nations other than the U.S.: see link.

Support can be meant well but hurtful to the person in mental anguish – some commonly used statements that may make a person with suicidal thoughts or actions feel worse: themighty.com.

What to say – some helpful brief tips: see link.

Symptoms or other lifestyle changes in a person that may indicate risk for suicidal thoughts or actions: see link

I have no affiliation with Epsom salt companies – it just really works well.

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Might Alzheimer’s involve an infection-leading to inflammation?

With the disappointing results regarding medications to reduce the levels of protein build-up involved with Alzheimer’s dementia there has been a renewed interest in the question of whether an underlying infection is causing the excess inflammation. The protein build-up may be an immune reaction that normally may help fight infection but in Alzheimer’s dementia builds up to damaging levels. Read more: https://www.npr.org/sections/health-shots/2018/09/09/645629133/infectious-theory-of-alzheimers-disease-draws-fresh-interest?

Strategies to reduce oxidative stress and inflammation (previous post with a summary of possible strategies that may help) are still likely to be helpful but if infection is involved an antiviral or antibiotic may also be helpful, especially if used ten or twenty years prior to when more obvious symptoms occur – so research scientists also look for low cost, low risk screening methods to help identify people with early stages such as the excess protein build-up.

million + search results for more reading on what is known about amyloid beta protein and it’s role against infection: intracellular infectious pathogen amyloid beta protein

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Myelin and Neuroscience, the short story

Well, 800+ pages of Neuroscience textbook later, (1), the short story on myelin regeneration is – while regrowth is somewhat possible to damaged areas outside of the brain, it doesn’t really happen much within the brain. Preventing breakdown and maintaining or adding to the synaptic connections that exist may be a more realistic goal. The chemical signals that occur from inflammatory white blood cells can lead to increased breakdown of cells and myelin, and may also cause increased production of unnecessary protein or cells, somewhat like building scar tissue to wall off a damaged area – but if inflammation is occurring throughout the brain than large areas of the brain are developing the scar tissue.

In addition to stopping the causes of inflammation and providing the body with adequate nutrients and antioxidants to cope with oxidative stress, the “use it or lose it” principle sometimes mentioned in exercise may apply to the brain and synaptic connections. Staying mentally and socially active as well as physically active is helpful for maintaining the synaptic connections and nerve connections that connect brain cells with each other and with the muscles and rest of the body parts. If synaptic connections aren’t used they may be more likely to be lost, dismantled for spare parts possibly if there is some nutrient deficiency.

The nerve connections between cells can be as long as an arm or a leg for some that connect the spinal cord with muscles in the hand or foot and the synaptic connection is right the very end. The route between is like a little tunnel where protein and signalling chemicals are transported from the cell body in the spine all the way to the synaptic junction near a nerve cell in the hand or foot. Energy producing mitochondria also travel along this route from the cell body out to the synapse. Aging seems to cause a breakdown in the internal transport system within the tunnel and then the synapse is less likely to be able to receive the mitochondria or other signaling proteins that are produced within the cell body. The body is a miracle but it needs help from adequate protein, essential fats, and adequate carbohydrate in addition to all the more specialized vitamins and minerals. 

I have more reading to do, review the introductory textbook and read more of the advanced topics in more specific research articles. The good news though remains – prevention of inflammation is possible with diet and lifestyle changes, (see the summary points in the last post), however the clean air, water, and avoidance of other environmental toxins might be more difficult depending on where you live.

Addition: Spinal cord injuries may have more potential for healing than brain injuries – brain cells that are involved with smelling are some of the few types of brain cells that continue to divide and replicate throughout life, possibly because they are more exposed to the outside world. Transplanting some of them into the area of a spinal injury has had some success for reversing paralyzing damage to the spine. (2)

Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1.  Neuroscience, 6th Edition, Editors D. Purves, G.J. Augustine, D. Fitzpatrick, W.C. Hall, A.S. LaMantia, R.D. Mooney, ML. Platt, L.E. White, (Sinauer Associates, Oxford University Press, 2018, New York) (Barnes&Noble)
  2. Anna Z, Katarzyna J-W, Joanna C, Barczewska M, Joanna W, Wojciech M. Therapeutic Potential of Olfactory Ensheathing Cells and Mesenchymal Stem Cells in Spinal Cord Injuries. Stem Cells International. 2017;2017:3978595. doi:10.1155/2017/3978595. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337375/